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Tract No. .bLot No.
CITY OF SAN JOSE BUILDING DEPARTMENX
APPLICATION FOR BUILDING PERMIT V J�
Date .Ji-�.✓ � - 119 76 Permit No. X-ZV� R
Application is hereby mad for a per 410 L7
a �story,Type Use Zone
at 8/�' 'G Occupancy
to be occupied only ase t
in accordance with Plans,Specifications a I -plan filedwe ith. P
Estimated Value of Improvements, $ Fire Sprinkler
Emer. Elect.
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any man-neer so as to violate the workmen's compensation laws of California, nn
Owner 13 U K �1.1J Address 1819 l L..AC 07-
By —� � O L- Address Z-Z j® CR V"h�.•l�
This permit shall expire and become null and void if the work authorized by it is not commenced within
120 days from the date issued or if the work is suspended or abandoned for a period of 120 days after
commencement. p ,Q //. L /
FINAL INSPECTION ,a I�-o/�V Z&U C,)k / G� 260-601 N
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-•• 1.LOCATION - 2.DATE RCD. .3.ITIME RCD:. •-
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• 4,READY AM 1 '„ 1 'ANYTIME 1 1 1 -5.TYPE OF 6.AREA 7. INSPT.MADE
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v• DAT
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• 8.APPROVED 1 9.REMARKS: ...._.L�.
. - DISAPPROVE I 1
' INSPECTOR
280 671
•. WHITE-FILE YELLOW-INSPECTORPINK-OFFICE
.LOCATION' - " 2. DATE RCD. G 3.TIME RCD.
• :4•READY AM ( 1 ANYTIME 5.TYPE OF :6�EA 7. INSPT.MADE
PM ( 1_ SPECIF INSPECT: ', TIME
• B.APPROVED ( 1 9.REMARKS: •c
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• INSPECTO - �2--�
v 280 671
WHITE-FILE' YELLOW-INSPECTOR �r'-
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